title: Trends in alcohol-attributable morbidity and mortality for Victoria, Australia from 2000/01 to 2009/10.
abstract: BACKGROUND
  To examine trends in alcohol-attributable morbidity (AAMorb) (2000/01-2009/10) and mortality (AAMort) (2000-07) by age, sex and region.
  
  
  METHODS
  Time-series analyses of population data for Victoria, Australia. We used joinpoint regression to quantify trends by estimating quarterly percent change (QPC) for rates of morbidity and mortality. We present the average QPC (AQPC) as a weighted average of QPCs. A test of parallelism was used to examine pairwise differences.
  
  
  RESULTS
  AAMorb increased significantly over time for Victoria (AQPC = 1.0%, 95% confidence interval 0.8-1.2). While females (1.6, 1.1-2.0), age groups 25-44 (1.0, 0.9-1.1) and 45-64 (1.2, 0.2-2.2), and metropolitan population (1.2, 0.5-1.9) were broad subgroups more at risk, multivariate analysis detected specific increases for metropolitan females aged 15-44 (1.8, 1.0-2.6) and 45+ (1.6, 0.2-3.0). Relatively greater increases in morbidity among metropolitan subgroups were widespread. AAMort remained stable for Victoria and for most subgroups, although significant declines in mortality were specifically experienced by metropolitan 15-24 (-2.0, -2.9 to -1.0) and 25-44 (-1.0, -1.7 to -0.3) age groups, and by regional males aged 45+ (-0.8, -1.3 to -0.3). Metropolitan males aged 45+ were a special high-risk population.
  
  
  CONCLUSIONS
  Our study has identified overlooked subgroups as being at increasing risk for alcohol-attributable chronic harm necessitating their inclusion in future policies for harm reduction.
authors.affiliation: Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, University of Melbourne, Melbourne, VIC, Australia Turning Point Alcohol and Drug Centre, Melbourne, VIC, Australia.
authors.forename: Harindra
authors.initials: H
authors.lastname: Jayasekara
authors.affiliation: The Institute for Social Science Research, The University of Queensland, Building 31B, Room 104, St Lucia, QLD, Australia ARC Centre for Excellence in Policing and Security, The University of Queensland, St Lucia, QLD, Australia.
authors.forename: Jason
authors.initials: J
authors.lastname: Ferris
authors.affiliation: Turning Point Alcohol and Drug Centre, Melbourne, VIC, Australia Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Matthews
authors.affiliation: Drug Policy Modelling Program, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre, Melbourne, VIC, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Livingston
authors.affiliation: Turning Point Alcohol and Drug Centre, Melbourne, VIC, Australia Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, Australia.
authors.forename: Belinda
authors.initials: B
authors.lastname: Lloyd
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D014505:Urban Population / Q000706:statistics & numerical data; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
keywords: alcohol consumption; joinpoint regression; morbidity; mortality; trends